ADHERENCE TO SELF–MONITORING OF BLOOD GLUCOSE AMONG TYPE 1 DIABETICS AND ITS IMPACT ON DIABETIC KETOACIDOSIS IN THE REAL WORLD
Keywords: Type 1 diabetes mellitus, Diabetic ketoacidosis, Self-monitoring of blood glucose
AbstractObjective: To determine the frequency of self-monitoring of blood glucose (SMBG) in type-1 diabetes mellitus (T1DM) patients, to find out factors that affect SMBG practice and to know SMBG influence on the frequency of diabetic ketoacidosis (DKA). Methodology: Using cross sectional study design and convenience non-probability sampling technique, 371 patients were interviewed regarding SMBG and factors that affect SMBG practice through a structured questionnaire in a single tertiary care center. Selected patients were having diabetes for 6 months or more and having age 10 years or above. Results: Among 371 patients, 59.3% were practicing SMBG using home glucometer but only 18.9% were monitoring their blood glucose level on daily basis. A sizeable proportion (37.2%) of patients stopped SMBG mainly due to financial restraints. Higher level of patient and family education as well as higher family income were independent predictors of SMBG practice. DKA frequency was significantly less (p =0.001) in SMBG adherent patients (64 per 100 patients per year) compared to non-adherent patients (92 per 100 patients per year) and was even more lower in patients who were performing multiple checks per day. Conclusion: This study has found that a significant number of patients were not performing SMBG at the recommended frequency due to financial constraints.SMBG was found useful and effective method to prevent DKA, a life threating complication of diabetes mellitus.